<div class="full-screen">
    <div class="page-group">
        <div class="page page-current nocoupon_contentBOX">
            <div class="content">

                <div class="coupon_page_top">
                    <a href="javascript:history.back()"><{img class="coupon_top_return" src="images/icon04.png" app="wap"}></a>
                    <div class="coupon_top_text">取消订单</div>
                </div>
                <div class="section" style="border-bottom: none;">
                    <form class="form" action="<{link app=b2c ctl=wap_member act=docancel}>" method="post">
                        <ul >
                            <li class="form-item">
                                <input type="hidden" name="order_cancel_reason[order_id]" value="<{$cancel_order_id}>">
                            </li>

                            <label>
                                <li class="form-item" style="margin:20px;">
                                    <input type="radio" name="order_cancel_reason[reason_type]" value="0" checked="checked">
                                    <{t}>不想要了<{/t}>
                                </li>
                            </label>

                            <label>
                                <li class="form-item" style="margin:20px;">
                                    <input type="radio" name="order_cancel_reason[reason_type]" value="1">
                                    <{t}>支付不成功<{/t}>
                                </li>
                            </label>

                            <label>
                                <li class="form-item" style="margin:20px;">
                                    <input type="radio" name="order_cancel_reason[reason_type]" value="2">
                                    <{t}>价格较贵<{/t}>
                                </li>
                            </label>

                            <label>
                                <li class="form-item" style="margin:20px;">
                                    <input type="radio" name="order_cancel_reason[reason_type]" value="3">
                                    <{t}>缺货<{/t}>
                                </li>
                            </label>

                            <label>
                                <li class="form-item" style="margin:20px;">
                                    <input type="radio" name="order_cancel_reason[reason_type]" value="4">
                                    <{t}>等待时间过长<{/t}>
                                </li>
                            </label>

                            <label>
                                <li class="form-item" style="margin:20px;">
                                    <input type="radio" name="order_cancel_reason[reason_type]" value="5">
                                    <{t}>拍错了<{/t}>
                                </li>
                            </label>

                            <label>
                                <li class="form-item" style="margin:20px;">
                                    <input type="radio" name="order_cancel_reason[reason_type]" value="6">
                                    <{t}>订单信息填写错误<{/t}>
                                </li>
                            </label>

                            <label>
                                <li class="form-item" style="margin:20px;">
                                    <input type="radio" name="order_cancel_reason[reason_type]" value="7">
                                    <{t}>其他<{/t}>
                                </li>
                            </label>

                            <li >
                                <div class="c-g" style="border: none;">
                                    <input class='x-input' type="text" name="order_cancel_reason[reason_desc]" placeholder="您还想说些什么？(50个字以内)">
                                </div>
                            </li>

                            <li >
                                <div class="form-actions"><button style="background: #d1bb7f;border: none;" type="submit" class="btn btn-caution act-subscribe" rel="_request"><span><span>提交</span></span></button></div>
                            </li>
                        </ul>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
